No abstract

(J Epidemiol Community Health 1999;53:277-282)

Objective: The objective of this study was to describe mean macronutrient and food intakes in the Baltic republics, with a particular focus on fat, vegetable and fruit consumption. Design: Cross-sectional study. Setting: Data from surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used. Information was collected using a 24 h recall of dietary intake and an interviewer-administered questionnaire. Subjects: Representative national samples of adults were selected. All those with information from the dietary recall were included in the study (Estonia: n 2015; Latvia: n 2300; Lithuania: n 2094). Results: The mean proportion of energy from fat was high in each country, but particularly in Lithuania (44%) and Latvia (42%) compared with Estonia (36%). In contrast, percentage energy from carbohydrate, protein and alcohol was higher in Estonia. Mean protein intake was generally suf®cient if not high in some population sub-groups. Median vegetable intakes were very low (`200 gaday) in each country, particularly in Latvia. While 78% of the Lithuanian respondents consumed vegetables daily, this was the case in only 60% of the Latvian and 48% of the Estonian respondents. Conclusions: This study suggests that there is a pressing need to replace high-fat energy dense foods by foods rich in complex carbohydrates and dietary ®bre, such as vegetables and fruits, in the Baltic republics. This could provide the populations with a reduced risk and increased protection against non-communicable diseases. These issues will need to be tackled through comprehensive food and nutrition policies and health promotion campaigns.

Objectives: As beliefs and knowledge about the possible effects of foods on health can influence food behaviours, this study examined selected dietary beliefs in the Baltic countries and the association of beliefs related to salt intake and to types of fat with food behaviours. Design: A cross-sectional study. Setting: Data from three surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used to describe the prevalence of dietary beliefs in these countries and to investigate the association between beliefs and behaviours (using logistic regression). Subjects: Representative national samples of adults were selected in each country (Estonia, n 2018; Latvia, n 2308; Lithuania, n 2153X Results: Misunderstood concepts (myths) related to dietary salt, types of fat, meat consumption and bread and potatoes were observed in high proportions of the population. Education level was an important correlate of beliefs related to salt intake and types of fat, people with a higher education level being more likely to be familiar with these issues. Correct beliefs were not consistently associated with healthier behaviours (e.g. less frequent use of salt at the table and use of non-animal fats for cooking), except for salt intake in Estonia. Conclusions: Several misunderstood dietary concepts (myths) are still prevalent in the Baltic countries. Correct beliefs related to salt intake and types of fat were not consistent predictors of healthier food behaviours. In-depth qualitative investigations are needed to better describe and understand dietary beliefs and attitudes in the Baltic countries, and to identify barriers to the adoption of healthy food habits.

Objective: Previously recorded rates of obesity in the Baltic Republics have been among the highest in the world although little is known about how they vary within the population. This study investigates the distribution of body mass index (BMI) and obesity in these countries. Design: Three cross-sectional surveys conducted in the summer of 1997. Setting: Estonia, Latvia and Lithuania. Subjects: Representative national samples of adults with measured weight and height (Estonia: n = 1154; Latvia: n = 2292; Lithuania: n = 2096). Results: Between-country differences are particularly large among women: women from Latvia and Lithuania are approximately three times as likely to be obese as those from Estonia (17.4%, 18.3%, 6.0% respectively); only about one-third of this difference is explained by the sociodemographic and behavioural factors studied. In men, the prevalence of obesity varied only slightly among countries (Estonia: 9.9%; Latvia: 9.5%; Lithuania: 11.4%). While the prevalence of obesity increases with age within each republic, particularly in women, it is not associated with nationality or urban/ rural region, and no consistent association is observed with income. Obesity is inversely related to education in Latvia and in Lithuanian women. Latvian men and women and Lithuanian men who smoked had a lower prevalence of obesity than non-smokers. Leisure time physical activity was not associated with obesity. Conclusions: Obesity is a major health problem in the Baltic Republics, particularly among Latvian and Lithuanian women. The lack of association between obesity and most demographic, socioeconomic and behavioural factors suggests that the problem is generalized. Health promotion strategies aiming at preventing and controlling excess weight gain in the Baltic Republics will need to target the general population.